Efficacy of laparoscopic mesh-augmented hiatoplasty in GERD and symptomatic hiatal hernia. Study using combined impedance-pH monitoring.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Georg R LinkeJan Borovicka

Abstract

Laparoscopic fundoplication is the standard antireflux procedure. However, side effects such as gas bloating indicate that the procedure is not unproblematic. Laparoscopic mesh-augmented hiatoplasty (LMAH) might be an alternative operation aimed at restoring the intra-abdominal part of the esophagus and reducing the size of the diaphragmatic hiatus. The aim of this study was to prospectively evaluate gastroesophageal reflux disease symptoms and gastroesophageal reflux before and after LMAH using 24 h impedance-pH monitoring (MII-pH). Twenty patients underwent MII-pH monitoring pre- and 3 months post-LMAH. Symptoms were assessed using the Gastrointestinal Symptom Rating Scale questionnaire. LMAH reduced the mean (SD) reflux syndrome score [pre-op 4.5 (1.7) vs post-op 1.4 (0.9); p<0.001], median (25th-75th percentile) distal %time pH<4 [4.9 (3.4-10.3) vs 1.0 (0.3-2.5) %; p=0.001) and total number of liquid reflux episodes [27.5 (17.5-38.3) vs 18 (7.3-29.3); p<0.05] without changing the number of gas reflux episodes [12 (6-34.3) vs 13.5 (6-20); p=0.346). All patients reported no limitation of their ability to belch. LMAH significantly reduces reflux symptoms and esophageal acid exposure without interfering with the ability to vent...Continue Reading

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Citations

Sep 26, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hasan Fevzi BatirelMustafa Yüksel
Dec 22, 2011·European Journal of Gastroenterology & Hepatology·Salman NusratKlaus Bielefeldt

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